Traumatic upper-limb amputation: The process toward acceptance.

Area of Science:

• Trauma surgery
• Psychological impact of amputation
• Grief and coping mechanisms

Background:

• Traumatic upper-limb amputation (TULA) can lead to pathological grief (PG) in one-third of patients.
• The coping experiences of the remaining TULA patients require further investigation.
• Understanding factors influencing PG development is crucial for patient care.

Purpose of the Study:

• To determine the rate of TULA patients who cope effectively without developing PG.
• To identify factors that facilitate or hinder coping with TULA consequences.
• To assess the long-term outcomes for TULA survivors.

Main Methods:

• Retrospective clinical study over 11 years.
• Assessment using questionnaires, including the Inventory of Complicated Grief (ICG).
• Analysis of physical, psychological, social, functional, aesthetic, and epidemiological factors; statistical analysis with p<0.05.

Main Results:

• Greater functional and social impacts were observed in patients with PG.
• Thumb amputation was associated with higher PG rates, while metacarpal base amputations showed lower rates.
• Patients with PG more frequently underwent neuroma resection or stump revision surgery.

Conclusions:

• Less than 50% of TULA patients achieve complete recovery.
• Patient acceptance of their new situation is more critical for long-term prognosis than amputation level.
• Comprehensive, long-term patient support is essential, addressing psychological needs beyond physical healing.